Patient reported outcomes measures (PROMs) trajectories after elective hip arthroplasty: a latent class and growth mixture analysis

Davide Golinelli; Alberto Grassi; Dario Tedesco; Francesco Sanmarchi; Simona Rosa; Paola Rucci; Marilina Amabile; Monica Cosentino; Barbara Bordini; Maria Pia Fantini; Stefano Zaffagnini

doi:10.1186/s41687-022-00503-5

Patient reported outcomes measures (PROMs) trajectories after elective hip arthroplasty: a latent class and growth mixture analysis

J Patient Rep Outcomes. 2022 Sep 9;6(1):95. doi: 10.1186/s41687-022-00503-5.

Authors

Affiliations

¹ Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum - University of Bologna, Via San Giacomo 12, 40126, Bologna, Italy. davide.golinelli@unibo.it.
² IIa Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.
³ Directorate-General Personal Care, Health and Welfare, Emilia-Romagna Region, Viale Aldo Moro, 21, 40127, Bologna, Italy.
⁴ Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum - University of Bologna, Via San Giacomo 12, 40126, Bologna, Italy.
⁵ Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.

Abstract

Background: Patient-reported outcome measures (PROMs) are an extensively used tool to assess and improve the quality of healthcare services. PROMs can be related to individual demographic and clinical characteristics in patients undergoing hip arthroplasty (HA). The aim of this study is to identify distinct subgroups of patients with unique trajectories of PROMS scores and to determine patients' features associated with these subgroups.

Methods: We conducted a prospective, cohort study in which PROMs questionnaires (Euro Quality 5 Dimensions 3L, EQ-5D-3L, Euro-Quality-Visual-Analytic-Score, EQ-VAS, Hip disability and Osteoarthritis Outcome Score, HOOS-PS) were administered to patients undergoing elective HA pre-operatively, and at 6 and 12 months after surgery. For each measure, latent class growth analysis and growth mixture models were used to identify subgroups of patients with distinct trajectories of scores. Demografic and clinical predictors of the latent classes in growth mixture model were identified using a 3-step approach.

Results: We found three distinct trajectories for each PROM score. These trajectories indicated a response heterogeneity to the HA among the patients (n = 991). Patient's gender, ASA score, and obesity were significantly associated with different PROMs trajectories.

Conclusions: We identified three distinct trajectories for each of the three PROMs indicators. Several demographic and clinical characteristics are associated with the different trajectories of PROMs at 6 and 12 months after HA and could be used to identify groups of patients with different outcomes following HA surgery. These findings underline the importance of patient-centered care, supporting the usefulness of integrating PROMs data alongside routinely collected healthcare records for guiding clinical care and maximizing patients' positive outcomes.

Trial registration: Protocol version (1.0) and trial registration data are available on the platform www.

Clinicaltrial: gov with the identifier NCT03790267, posted on December 31, 2018.

Keywords: Arthroplasty; Hip; Implant registry; PROMs; Patient-reported outcome measures; Quality improvement.

Associated data

ClinicalTrials.gov/NCT03790267